Abstract
The aim of this study was to evaluate the effect of vaginal delivery on both ACTH and catecholamines (DA, NE, E) secretion in the mother, the fetus (umbilical artery) and the newborn. Blood samples were obtained from 19 normal pregnant women and the corresponding umbilical cords, and from the newborns. Seventeen normal nonpregnant women, matched for age and parity, were also included in the study as “nonpregnant controls”. The results demonstrate that in the mother, plasma catecholamines (CA) concentrations during labor and delivery are elevated above the values reported for normal nonpregnant women and there is a predominant E response. The concentrations of CA in umbilical arteries are very high compared to those in the corresponding mother and they fall rapidly after birth. Unlike that in the mother, the predominant CA response to parturition in the fetus and newborn infant is NE. The extraction rate of DA, NE and E from placenta is approximately 60%. The peripheral plasma levels of ACTH in pregnant women during labor are twice and 10 times as high as those observed in the corresponding umbilical arteries and in nonpregnant women respectively. At delivery they increase further. No significant differences are found between the values measured in the arterial cord blood and those in the venous cord blood and in the newborns. A way of explaining the prevalence of E and the higher ACTH/E ratio found in the mother in comparison with the fetus could be that in the mother the stress response to parturition is regulated mainly by the pituitary-adrenal axis, whereas in the fetus there is a prevalent stimulation of the sympathetic nervous system.
Similar content being viewed by others
References
Lederman R.P., McCann D.S., Work B. Endogenous plasma epinephrine and norepinephrine in last-trimester pregnancy and labor. Am. J. Obstet. Gynecol. 125: 5,1977.
Irestedt L., Lagercrantz H., Hjemdahl P., Hagnevick K., Beifrage P. Fetal and maternal plasma catecholamine levels at elective cesarean section under general and epidural anesthesia versus vaginal delivery. Am. J. Obstet. Gynecol. 142: 1004, 1982.
Jones C.M., Greiss F.C. The effect of labor on maternal and fetal circulating catecholamines. Am. J. Obstet. Gynecol. 144: 149, 1982.
Bistoletti P., Nylund L., Lagercrantz H., Hjemdahl P., Strom P. Fetal scalp catecholamines during labor. Am. J. Obstet. Gynecol. 147: 785,1983.
Jouppila R., Puolakka J., Kauppila A., Vuori J. Maternal and umbilical cord plasma noradrenaline concentrations during labour with and without segmental extradural analgesia, and during cesarean section. Br. J. Anaesth. 56: 251, 1984.
Peleg D., Munsick R.A., Diker D., Goldman J.A., Ben-Jonathan N. Distribution of catecholamines between fetal and maternal compartments during human pregnancy with particular emphasis on L-dopa and dopamine. J. Clin. Endocrinol. Metab. 62: 911, 1986.
Csontos K., Rust M., Hollt V. Elevated plasma beta-endorphin levels in pregnant women and their neonates. Life Sci. 25: 835, 1979.
Genazzani A.R., Facchinetti F., Parrini D. Beta-lipotropin and beta-endorphin plasma levels during pregnancy. Clin. Endocrinol. (Oxf.) 14: 409, 1981.
Goland R.S., Waedlaw S.L., Stark R.I. Human plasma beta-endorphin during pregnancy, labor and delivery. J. Clin. Endocrinol. Metab. 52: 74, 1981.
Dokumov S.I., Milanov S.C., Trepetshov S.P. Adrenocorticotrophic hormone in plasma of mother and newborn. Br. J. Obstet. Gynaecol. 81: 220, 1974.
Kauppila A., Tuimala R., Haapalahti J. Maternal adrenocorticotrophic hormone and Cortisol during labour and vaginal delivery. J. Obstet. Gynaecol. Brit. Cwlth. 81: 691, 1974.
Carr B.R., Parker C.R. Jr., Madden J.D., MacDonald P., Porter J.C. Maternal plasma adrenocorticotropin and Cortisol relationship throughout human pregnancy. Am. J. Obstet. Gynecol. 139: 416, 1981.
Fettes I., Fox J., Kuzniak S., Shime J., Gare D. Plasma levels of immunoreactive beta-endorphin and adenocorticotropic hormone during labor and delivery. Obstet. Gynecol. 64: 359, 1984.
Lederman R.P., Lederman E., Work B.A. Jr., McCann D.S. The relationship of maternal anxiety, plasma catecholamines, and plasma Cortisol to progress in labor. Am. J. Obstet. Gynecol. 132: 495, 1978.
Irestedt L., Lagercrantz H., Beifrage P. Causes and consequences of maternal and fetal sympathoadrenal activation during parturition. Acta Obstet. Gynecol. Scand. (Suppl.) 118: 111, 1984.
Puolakka J., Kauppila A., Tuimala R., Pakarinen A. Fetal adrenocorticotropin hormone and prolactin at delivery. Obstet. Gynecol. 60: 71, 1982.
Winters A.J., Oliver C., Colston C., MacDonald P., Porter J.C. Plasma ACTH levels in the human fetus and neonate as related to age and parturition. J. Clin. Endocrinol. Metab. 39: 269, 1974.
Melmon L.K. The endocrinologic function of selected autacoids: catecholamines, acetylcholine, serotonin, and histamine. In: Williams R.H. (Ed.), Textbook of Endocrinology. W.B. Saunders Company, Philadelphia, London, Toronto, 1981, p. 515.
Nishida S., Matsuki M., Adachi N., Horino M., Yoneda M., Endoh M., Oyama H., Kikuoka M., Otsuka R., Ishii R., Andoh C. Pituitary-adrenocortical response to metoclopramide in patients with acromegaly and prolactinoma: a clinical evaluation of catecholamine-mediated adrenocorticotropin secretion. J. Clin. Endocrinol. Metab. 64: 995, 1987.
Smelik P.G., Berkenbosch F., Vermes I., Tilders F.J.H. The role of catecholamines in the control of the secretion of proopiocortin-derived peptides from the anterior and intermediate lobes and its implications in the response to stress. In: Bhatnagar A.S. (Ed.), The anterior pituitary gland. Raven Press, New York, 1983, p. 113.
Peuler J.D., Johnson G.A. Simultaneous single isotope radioenzymatic assay of plasma norepinephrine, epinephrine and dopamine. Life Sci. 21: 625, 1977.
Eliot R.J., Lam R., Leake R.D., Hobel C.J., Fisher D.A. Plasma catecholamine concentrations in infants at birth and during the first 48 hours of life. J. Pediatr. 96: 311, 1980.
Lagercrantz H., Bistoletti P. Catecholamine release in the newborn infant at birth. Pediatr. Res. 11: 889, 1973.
Nakai T., Yamada R. The secretion of catecholamines in newborn babies with special reference to fetal distress. J. Perinat. Med. 6: 39, 1978.
Nicolopoulos D., Agathopoulos A., Galamakos-Tjarowiati M., Stergiopoulos C. Urinary excretion of catecholamines by full-term and premature infants. Pediatrics 44: 262, 1969.
Greenberg R.E., Gardner L. The excretion of free catecholamines by newborn infants. J. Clin. Endocrinol. Metab. 20: 1207,1960.
Zeisel H., Kuschke F. Die catechinamine adrenalin und noradrenalin in harn des kindes. Klin. Wochenschr. 37: 1168, 1959.
Euler U.S., Frantisson C., Heistrom J. Adrenaline and noradrenaline output in urine after unilateral and bilateral adrenalectomy in man. Acta Physiol. Scand. 31: 1, 1954.
Paulick R., Kastendieck E., Wernze H. Catecholamines in arterial and venous umbilical blood: placental extraction, correlation with fetal hypoxia, and transcutaneous partial oxygen tension. J. Perinat. Med. 13: 31, 1985.
Reilly F.D., Rusell P.T. Neurohistochemical evidence supporting an absence of adrenergic and cholinergic innervation in the human placenta and umbilical cord. Anat. Rec. 188: 277, 1977.
Bacigalupo G., Langner K., Schmidt S., Saling E. Plasma immunoreactive beta-endorphin, ACTH and Cortisol concentrations in mothers and their neonates immediately after delivery — their relationship to the duration of labor. J. Perinat. Med. 15: 45, 1987.
Rees L.H., Burke C.W., Chard T., Evans S.W., Letchworth A.T. Possible placental origin of ACTH in normal human pregnancy. Nature 254: 620, 1975.
Mukherjee J., Swyer G.I.M. Plasma Cortisol and adrenocorticotrophic hormone in normal men and nonpregnant women, normal pregnant women and women with pre-eclampsia. Br. J. Obstet. Gynaecol. 79: 504, 1972.
Genazzani A.R., Petraglia F., Parrini D., Nasi A., Angioni G., Facchinetti F., Facchini V., Volpe A. Lack of correlation between amniotic fluid and maternal plasma contents of β-endorphin, β-lipotropin, and adrenocorticotropic hormone in normal and pathologic pregnancies. Am. J. Obstet. Gynecol. 148: 198, 1984.
Sasaki A., Shinkawa O., Margioris A.N., Liotta A.S., Sato S., Murakami O., Go M., Shimizu Y., Hanew K., Yoshinaga K. Immunoreactive corticotropin-releasing hormone in human plasma during pregnancy, labor and delivery. J. Clin. Endocrinol. Metab. 64: 224, 1987.
Goland R.S., Wardlaw S.L., Stark R.I., Brown L.S., Frantz A.G. High levels of corticotropin releasing hormone immunoreactivity in maternal and fetal plasma during pregnancy. J. Clin. Endocrinol. Metab. 63: 1199, 1986.
Petraglia F., Sawchenko P.E., Rivier J., Vale W. Evidence for local stimulation of ACTH secretion by corticotropin-releasing factor in human placenta. Nature 328: 717, 1987.
Rudman D., Moffit S.D., Fernhoff P.M., Blakston D.R., Faraj B.A. Epinephrine deficiency in hypocorticotropic hypopituitary children. J. Clin. Endocrinol. Metab. 53: 722, 1981.
Mpoy M., Kolanowski J. Urinary catecholamine excretion in patients with secondary adrenocortical insufficiency. J. Endocrinol. Invest. 9: 253, 1986.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Costa, A., De Filippis, V., Voglino, M. et al. Adrenocorticotropic hormone and catecholamines in maternal, umbilical and neonatal plasma in relation to vaginal delivery. J Endocrinol Invest 11, 703–709 (1988). https://doi.org/10.1007/BF03350923
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03350923